Interview with “Refuse to Regain” author Dr. Barbara Berkeley 

Dr. Barbara Berkeley constantly explains that weight management isn't like a balloon; you don't just deflate to a new body and that's that. The process is closer to exchanging a dull piece of latex for a shiny Mylar. Similar, to be sure, but it's made of different stuff.

And she walks her talk. Aside from sustaining a 20-pound weight loss herself, her book "Refuse to Regain" and the web site of the same name she co-authors with blogger Lynn Haraldson-Bering explores the difference between weight loss and weight management. Considering how little material exists on the subject, Berkeley's work is like a light in the darkness.

"For years I've seen people come in, lose weight and then regain it," Berkeley says. "Weight loss was really never the issue. In fact, people were pretty good at that. The problem was maintaining the weight that they lost. There were no materials for teaching people about that." So she wrote her own.

In "Refuse to Regain," Berkeley explains the side effects of yo-yo dieting on the body, the importance of "Primarian" (or natural, whole-food based) diet and a list of strategies for maintaining weight on a day-to-day basis. Berkeley designed the book to be written with frank honesty. "I wanted to start with the tough message that you have to basically remake your life in a fundamental way if you're going to have long term success," she says. "The first time you hear this, it sounds kind of harsh, but once someone has gained their weight back, they are often willing to reconsider and say, 'You know, that message may not be all that crazy.'"

Berkeley drew from her experience as Director of Weight Management Services for Lake Hospital Systems in Cleveland, Ohio, among other affiliations. She became interested in weight loss and weight management being part Mt. Sinai Medical Weight Management Program in Cleveland in 1988, and in 2000 she opened her own practice, Weight Management Partners, Inc. In her practice, she sees anywhere from 50-70 patients in a week seeking help on losing weight and keeping their success going.

Combining her practical experience with crafting "Refuse to Regain," Berkeley found a number of issues in addressing the subject matter; the first is the lack of terminology communicating the differences between weight loss and weight maintenance. "There is no language for maintenance, and I think it's important that there's a vocabulary," Berkeley says. "On the web site, people really pick up on terms like POW (Previously Over Weight), or SAD (Standard American Diet). These kinds of words just convey something quickly. It's a kind of shorthand. Basically, I think the language surrounding weight maintenance is lacking and it needs to be created."

These concerns might sound pedantic on first thought, but determining a vocabulary for maintenance is important. It clarifies and distills some of the issues in sustaining weight loss that may be overlooked -- mainly because they're subtle. Given that, it's no surprise the country has such trouble understanding the difference between losing weight and keeping it off -- they language for the two is interchangeable.

But Berkeley considers the issue is just as psychological as linguistic. Once someone chooses to lose weight, they find it an exciting process, she says. And once you hit goal there's thud -- the dreaded "now what?" question. The term "Maintenance," by comparison, she considers tepid and dull. "The word 'maintain' means that nothing changes and it's pretty hard to get excited about just keeping things the same," she says. "I don't think that "maintenance" conveys what successful maintainers do. What's actually happening is that they are creating an interesting new life that they prefer.

"The problem is, most scientists don't know what that better way of living entails, which speaks to the more important issue surrounding maintenance is the nature of scientific studies on dieting," Berkeley says. Doing studies that give good information about optimal diet is very tough. To get a good scientific study, you have to be able to compare factors that are very specifically controlled ... 100 people in hospital, for example, with the same sleep, same exercise, and different foods or calories. Then you can compare groups," she says. "Most conclusions about optimal diet are based on studies of people who are free living … (and) there are too many variables to control. "

It doesn't help that these studies are then bombasted by the media, preaching them as gospel when they might not be true. In her research, found little to work from beyond various reports from The National Weight Control Registry and various information on the dangers of constant weight fluctuation. Ultimately, she discovered anecdotal evidence, usually decried in most scientific studies for being inconclusive, is more powerful than what few existing facts.

"Weight loss is one area in which people who have been successful, who found solutions for themselves, can have more useful information to offer than some studies," she says. "They actually have gotten a result and it's important that their experience be looked at. You can learn a tremendous amount from people who have actually succeeded."

Dr. Berkeley's point of view and body of work is a largely refreshing shift from stereotypical weight loss conversations with doctors and scientists. Let's face it, they usually talk to, talk about, or talk down to those who struggle with their weight -- whether they have weight or even if they've already lost weight.

Berkeley, like the scientists behind The National Weight Control Registry or even plastic surgeons such as Peter Rubin, choose a different route -- she actually started listening. And that's almost revolutionary. "Refuse to Regain" is available at, and I highly recommend her web site for a different flavor of post-weight discussion.

Russ LaneComment